Problem: To assess the rate and incidence of medication error and antibiotic resistance. To develop the monitoring and minimization programme. To promote cost effective treatment.  To develop strategy for reducing the risk of medication error. Approach: Conducted a prospective observational study over 6 months in a tertiary care hospital’s ICU. The patients meeting specific criteria were included in the study. Microsoft excel was used for data compilation. Statistical analysis through SPSS software revealed significant findings. Findings: We have collected a total of 375 drug related problems including medication errors, adverse drug reactions and also include patients for antibiotic stewardship programme. During the study, Distribution of medication error in according to age and gender shows that medication errors repeatedly occur in the male patients (66%) compared with female patients (34%). While considering ICUs, the highest number of medication errors was found in the department of NMICU with 38%. The Department of MICU consists of 29.3% errors and Department of SICU consists of 26%. The Department CICU consists of 6% errors and In the Department of MDICU, least number of medication errors were occurred with 0.7%.Amongthe 150 subjects in the study 59.3% were occurred by the Doctors. 40% of Medication errors were made by Nurses and 0.7% of Medication error was due to the Pharmacist. 60% of the reported errors were Prescribing errors, 37.3% of the errors were Drug administration errors and 2.7% were Dispensing error. Among the 75 subjects reported with adverse drug reaction in the study 54.7% were females and 45.3% were males. Among the 75 cases, 81.3% subjects recovered from the adverse drug reaction occurred and 18.7% subjects were recovering from the adverse event. The result of antibiotic stewardship programme shows that among the 150 subjects in the study, 57.3% were males and 42.7% were females. The stewardship programme was carried out in 5 different ICUs. Out of this 38% was taken from MICU, 26% was taken from SICU, 20.7% was taken from MDICU, 10% was taken from NMICU and 5.3% was taken from CICU.  Conclusion: Comprehensive analysis of medication charts of IP patients across five major intensive care units including MICU, MDICU, NMICU, SICU and CICU revealed spectrum of drug related problems spanning from medication errors to adverse drug reactions. Employing various interventional tools, pre and post ward rounds , and distinct inclusion criteria we categorized subtypes of these issues .The study underscored the pivotal role of clinical pharmacist in mitigating the rate of medication errors, show casing a significant reduction through direct reviews of medication charts and collaborative interaction with nurses and physicians .This emphasizes the vital contribution of clinical pharmacist in enhancing patient safety and overall quality of health care delivery in intensive care settings.